Provider Demographics
NPI:1457620973
Name:SPRINGS VALLEY ASSISTED LIVING, INC.
Entity Type:Organization
Organization Name:SPRINGS VALLEY ASSISTED LIVING, INC.
Other - Org Name:DESERT SPRINGS SENIOR LIVING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:
Authorized Official - First Name:LEE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-401-1369
Mailing Address - Street 1:6650 W FLAMINGO RD
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103-2142
Mailing Address - Country:US
Mailing Address - Phone:702-732-2800
Mailing Address - Fax:702-873-5316
Practice Address - Street 1:6650 W FLAMINGO RD
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103-2142
Practice Address - Country:US
Practice Address - Phone:702-732-2800
Practice Address - Fax:702-873-5316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-29
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV410AGC-32310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV410AGC-32OtherBUREAU OF HEALTH CARE QUALITY & COMPLIANCE